EP2312554B1 - Medical patient simulator - Google Patents

Medical patient simulator Download PDF

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Publication number
EP2312554B1
EP2312554B1 EP10168541.0A EP10168541A EP2312554B1 EP 2312554 B1 EP2312554 B1 EP 2312554B1 EP 10168541 A EP10168541 A EP 10168541A EP 2312554 B1 EP2312554 B1 EP 2312554B1
Authority
EP
European Patent Office
Prior art keywords
plate
air
strap
lung
torso
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Not-in-force
Application number
EP10168541.0A
Other languages
German (de)
English (en)
French (fr)
Other versions
EP2312554A1 (en
EP2312554A9 (en
Inventor
Øystein GOMO
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Laerdal Medical AS
Original Assignee
Laerdal Medical AS
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Laerdal Medical AS filed Critical Laerdal Medical AS
Publication of EP2312554A1 publication Critical patent/EP2312554A1/en
Publication of EP2312554A9 publication Critical patent/EP2312554A9/en
Application granted granted Critical
Publication of EP2312554B1 publication Critical patent/EP2312554B1/en
Not-in-force legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
    • G09B23/30—Anatomical models

Definitions

  • the present invention regards a medical patient simulator, in particular a simulator for simulating an infant comprising; a torso having a chest skin and containing at least one lung, with the option of altering the compliance of the at least one lung, where the at least one lung is disposed between a first plate and second plate in the torso, the spacing of the plates being adjustable, the second plate being fixed relative to the torso, and the first plate being movable relative to the torso.
  • US 4 850 876 describes a medical patient simulator having a torso containing at least one lung. It also describes the option of altering the compliance of the lung. The lung is disposed between a middle rigid panel and a rear rigid panel, and the spacing of the places is adjustable. This simulator does not include the possibility of simulating intercostal contractions.
  • the invention concerns systems intended for patient simulators (particularly manikins) used for medical teaching and training. It is an object for a manikin to exhibit various signs of illness as well as both normal and abnormal bodily functions in order to allow the users to make a diagnosis and take corrective measures.
  • the background for the invention is a request from the market for a simulation of the breathing pattern called intercostal retractions, so as to provide a basis for diagnosing breathing problems in the patient.
  • Chest retractions occur when a patient has difficulties breathing due to an obstruction of the respiratory passage or severe asthma and the lungs use a great amount of force in order to get the air through.
  • the retractions are visible as a cavity in the diaphragm (the skin is "sucked” in between the ribs and at the lower edge of the ribs, i.e. below the sternum).
  • the invention comprises a pneumatically driven mechanism being adapted to force the first plate towards the second plate; a flexible means connecting the pneumatically driven mechanism to the second plate to provide the force between the first plate and second plate, said flexible means having an initial slack so that the first plate is free to move relative to the second plate when the pneumatically driven mechanism is inactive; and a strap that is attached to the chest skin for pulling down the chest skin providing an external visible depression of the chest skin below the sternum of the torso, in order to simulate intercostal retractions, the strap pulling being coupled to the lung inflation
  • this can be done by attaching or integrating an elastic strap to the inside of the chest skin in the middle of the area where retractions occur.
  • a pneumatic mechanism pulls this strap in a manner which is synchronized with the lungs' raising and lowering of the chest, giving the desired cavity in the skin.
  • the function can be switched on and off from the instructor's PC or via remote control.
  • the strap may be glued or welded to the chest skin. Most preferably the strap is moulded integrally with the rest of the skin. The latter allows for more efficient production.
  • the skin can be pulled down by pneumatics and a lever mechanism.
  • the skin can be pulled down by en electro-mechanical mechanism, e.g. an electric motor or a solenoid.
  • electro-mechanical mechanism e.g. an electric motor or a solenoid.
  • a strap magnetic material may be fixed to or moulded to the relevant area of the chest skin. Pull-down is carried out by activating an electromagnet placed a distance under the skin.
  • the retractions may occur as a result of suction on the underside of the area in question.
  • Such a solution may also be used to simulate intercostal and mid-clavicular retractions.
  • the suction effect can be produced by forming a closed space underneath the skin through:
  • Figure 1 is a longitudinal section through a patient simulator, showing part of a head 1 and part of a torso 2.
  • the torso 2 comprises a chest skin 3.
  • a shell 4 to represent ribs and sternum.
  • a first plate 5 which may also be termed an upper plate.
  • Under the plate 5 is one or preferably two lungs 6, one on the right side and one on the left side of the rib cage.
  • Under the lung(s) 6 is a second or lower plate 7.
  • An area of the chest skin 3 below the shell has a strap 8 attached to it or integrated into the chest skin. Preferably this is done by moulding the chest skin 3 and the strap 8 at the same stage.
  • the strap 8 is connected to a lever 9 designed to pull on the strap 8.
  • One end of the lever 9 is supported in a hinge 10.
  • an air cushion 11 Between the lever 9 and the upper plate 5 is an air cushion 11.
  • the air cushion 11 is connected via a hose 12 to a source of compressed air (not shown).
  • the lung 6 is connected to a source of compressed air (not shown) via a hose 13.
  • Figure 2 is a longitudinal section similar to Figure 1 . However, Figure 2 also shows a mechanism for reducing the plate's 5 mobility. This comprises a lever 14, one end of which is supported at a hinge 15. The opposite end of the lever 14 is connected to a flexible body 16.
  • the flexible body 16 is functionally engaged with the lower plate 7. To make sure the elastic strap does not prevent the plate 5 from moving in the case of normal lung compliance, the strap has some slack with respect to the plate 7, indicated at 17.
  • the strap 16 may be an endless elastic band, as shown.
  • An air cushion 18 is arranged between the plate 5 and the lever 14. This is connected to a source of compressed air (not shown) via a hose 19. When the air cushion fills with air the lever 14 is lifted to the position indicated by the dotted line at 14'. Thus the slack between the strap 16 and the plate 7 is reduced or eliminated. Upon subsequent filling of the lung 6 the strap 16, which acts between the lever 14 and the lower plate 7, will counteract the movement of the upper plate 5 away from the lower plate 7. This will make the lungs feel less compliant, as it becomes more difficult to fill them with air.
  • FIG 3 is a cross section through the torso 2 of a patient simulator, illustrating a back shell 20.
  • the back shell serves to reinforce the torso.
  • On the outside of the back shell 20 are two recesses 21 and 22, on the left and right sides of the torso, respectively.
  • In each recess 21, 22 is an air cushion 23 and 24, respectively.
  • the air cushions 23, 24 are connected to a source of compressed air (not shown) via respective hoses 25, 26.
  • Preferably rapid deflation of the air cushions is achieved by using a three-way valve (not shown) both for filling and emptying the air cushions. Filling and emptying takes place through the same hose 25, 26. Upon activation of the valve it opens for compressed air from the compressed-air source, and the air cushions are inflated. As soon as the valve is deactivated it closes to compressed air, and the air in the air cushion passes back through the valve and out into the atmosphere.
  • the air cushions can be provided with an orifice which allows rapid deflation after inflation.
  • the orifice is shaped so as to be too small to allow rapid inflation of the air cushion with a fast flow of compressed air, but large enough to give a rapid deflation when the flow of compressed air stops.
  • the air cushions 23, 24 can be used in the following modes:
  • Simulation of normal muscle movements Alternate and regular filling and emptying of air on the left and right sides.
  • Simulation of muscle spasms Rapid and irregular (arbitrary) filling and emptying (inflation and deflation) of the right and left air cushions.
  • the inflation and deflation may in some cases be complete and in some cases incomplete.
  • Figure 4 is a schematic view of a control system for regulating the filling of air cushions and/or lungs in a patient simulator.
  • a pneumatic actuator (e.g. air cushion or lung) 27 is connected to a hose 28.
  • the hose is connected to a purge valve 29 with an air outlet 30.
  • the hose 28 is also connected to a first air duct 31, which in turn is connected to a pressure sensor 32.
  • the air duct 31 is also connected to a second air duct 33, which in turn is connected to a fill valve 34.
  • the fill valve 34 is again connected to a source of compressed air (not shown) via an inlet 36.
  • the second air duct 33 includes a throttle regulator or nozzle 35.
  • the fill valve 34, the purge valve 29, the nozzle 35, the pressure sensor 32 and the first and second air ducts 31, 33 form a control unit 37 and are located in physical proximity to each other and at a distance from the actuator 27.
  • the fill valve When the actuator 27 is to be filled with air the fill valve is manipulated to the open position. At this the air flows via the second air duct 33 and the nozzle 35 into the first air duct 31 and on to the hose 28 and the actuator 27.
  • the nozzle 35 provides pressure equalization to make the pressure in the first air duct 31 (which is the pressure sensed by the pressure sensor 32) approximately equal to the pressure in the actuator 27.
  • the nozzle 35 will delay the inflation of the actuator 27 slightly but not significantly. Therefore the throttling of the nozzle 35 is a compromise between rapid filling of the actuator 27 and pressure equalization between the pressure sensor 32 and the actuator 27.
  • the arrangement of the nozzle 35 will therefore be dependent on the function of the actuator 27.
  • the throttling in the nozzle 35 must only restrict the air flow to the actuator to a small extent.
  • the preferred solution is one in which the pressure is measured in the actual actuator by connecting the pressure sensor directly to the volume therein via a separate hose.
  • the fill valve 34 closes when the pressure in the first air duct 31 reaches a desired value. If the actuator 27 is to be deflated again immediately (as in the case of a lung) the purge valve 29 is opened and the air is released.
  • the pressure in the actuator, hose 28 and the first air duct 31 will be higher than it was at the commencement of the previous inflation. However the pressure sensor will stop the inflation at the same pressure as before. Overinflation of the actuator and any rupturing of this are therefore prevented.
  • Figure 5 is a longitudinal section through the head 1 of the simulator.
  • the head 1 comprises an inflexible inner shell 41 covered in a soft skin 40.
  • a recess 45 in the inner shell 41.
  • an air cushion 43 connected to a source of compressed air (not shown) via a hose 42.
  • a flexible body 44 such as a block of foam rubber is arranged between the air cushion 43 and the skin 40.
  • the air cushion 43 is inflated from the air source via the hose 42, pushing the flexible body 44 against the skin 40, causing this to move outwards. This is indicated by the dotted line 40' and forms a swelling in the head 1.
  • the swelling in the head 1 will be visible and feel soft and yielding, as will be the case with a real patient. Releasing the air from the air cushion 43 will cause the swelling to disappear, as the flexible body 44 returns to the recess 45.
  • the manikin can also be provided with a similar device in the area where the smaller or rear fontanelle is found on an infant.
  • FIG. 6 shows an alternative solution for visualising the retraction function, which is also described with reference to Figure 1 .
  • the retraction function is achieved by attaching the lower end of the strap 8 to a rotating wheel in an eccentric fashion.
  • the rotating wheel is driven by a motor (not shown) and is attached to the upper plate 5 via a fastening stay 51.
  • Upon rotation of the wheel 50 this will produce a retraction of the chest skin 3, in the same manner as described above.
  • the frequency and timing of the retractions can be controlled by adjusting the wheel 50 rotation. It would be appropriate to replace the wheel 50 with a crank handle.
EP10168541.0A 2003-10-06 2004-10-06 Medical patient simulator Not-in-force EP2312554B1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
NO20034465A NO319063B1 (no) 2003-10-06 2003-10-06 Medisinsk pasientsimulator
EP04775079.9A EP1671299B1 (en) 2003-10-06 2004-10-06 Medical patient simulator

Related Parent Applications (6)

Application Number Title Priority Date Filing Date
WOPCT/NO20/04000298 Previously-Filed-Application 2004-10-06
PCT/NO2004/000298 Previously-Filed-Application WO2005032327A2 (en) 2003-10-06 2004-10-06 Medical patient simulator
EP04775079.9A Division-Into EP1671299B1 (en) 2003-10-06 2004-10-06 Medical patient simulator
EP04775079.9A Division EP1671299B1 (en) 2003-10-06 2004-10-06 Medical patient simulator
EP04775079.9 Division 2004-10-06
WOPCT/NO2004/000298 Previously-Filed-Application 2004-10-06

Publications (3)

Publication Number Publication Date
EP2312554A1 EP2312554A1 (en) 2011-04-20
EP2312554A9 EP2312554A9 (en) 2012-06-27
EP2312554B1 true EP2312554B1 (en) 2016-05-25

Family

ID=29417585

Family Applications (4)

Application Number Title Priority Date Filing Date
EP04775079.9A Not-in-force EP1671299B1 (en) 2003-10-06 2004-10-06 Medical patient simulator
EP10168541.0A Not-in-force EP2312554B1 (en) 2003-10-06 2004-10-06 Medical patient simulator
EP10168537.8A Not-in-force EP2312553B1 (en) 2003-10-06 2004-10-06 Medical patient simulator
EP10168543.6A Not-in-force EP2312555B1 (en) 2003-10-06 2004-10-06 Medical patient simulator

Family Applications Before (1)

Application Number Title Priority Date Filing Date
EP04775079.9A Not-in-force EP1671299B1 (en) 2003-10-06 2004-10-06 Medical patient simulator

Family Applications After (2)

Application Number Title Priority Date Filing Date
EP10168537.8A Not-in-force EP2312553B1 (en) 2003-10-06 2004-10-06 Medical patient simulator
EP10168543.6A Not-in-force EP2312555B1 (en) 2003-10-06 2004-10-06 Medical patient simulator

Country Status (9)

Country Link
US (2) US7857625B2 (zh)
EP (4) EP1671299B1 (zh)
JP (1) JP4639191B2 (zh)
CN (4) CN100557661C (zh)
AU (4) AU2004277841B2 (zh)
CA (1) CA2541724A1 (zh)
ES (4) ES2588054T3 (zh)
NO (1) NO319063B1 (zh)
WO (1) WO2005032327A2 (zh)

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CN1864185A (zh) 2006-11-15
EP1671299B1 (en) 2016-05-25
EP2312554A1 (en) 2011-04-20
ES2587690T3 (es) 2016-10-26
AU2004277841B2 (en) 2010-08-05
CN100557661C (zh) 2009-11-04
EP2312555B1 (en) 2016-01-13
EP2312553B1 (en) 2016-05-25
EP2312555A9 (en) 2012-06-27
EP2312553A1 (en) 2011-04-20
NO319063B1 (no) 2005-06-13
CN101483018A (zh) 2009-07-15
ES2564927T3 (es) 2016-03-30
ES2588053T3 (es) 2016-10-28
JP4639191B2 (ja) 2011-02-23
WO2005032327A2 (en) 2005-04-14
EP2312555A1 (en) 2011-04-20
AU2010202755B2 (en) 2013-05-23
WO2005032327A3 (en) 2005-05-26
CN101483018B (zh) 2010-12-29
US20100221689A1 (en) 2010-09-02
CN101447141A (zh) 2009-06-03
CN101452654B (zh) 2011-04-20
EP2312553A9 (en) 2012-06-27
ES2588054T3 (es) 2016-10-28
AU2010202756B2 (en) 2013-05-02
US20070087314A1 (en) 2007-04-19
AU2004277841A1 (en) 2005-04-14
CN101447141B (zh) 2012-01-25
EP1671299A2 (en) 2006-06-21
US7857625B2 (en) 2010-12-28
EP2312554A9 (en) 2012-06-27
AU2010202747A1 (en) 2010-08-05
CN101452654A (zh) 2009-06-10
AU2010202755A1 (en) 2010-09-02
NO20034465D0 (no) 2003-10-06
CA2541724A1 (en) 2005-04-14
AU2010202756A1 (en) 2010-08-12
JP2007507745A (ja) 2007-03-29

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